Person: AKALIN, EMİN HALİS
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AKALIN
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EMİN HALİS
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Publication Retrospective evaluation of colistin-resistant isolates in automated system by gradient diffusion method and broth microdilution method(Doc Design Informatics, 2019-04-01) Efe, Kadir; Tüzemen, Nazmiye Ülkü; TÜZEMEN, NAZMİYE ÜLKÜ; Akalın, Halis; AKALIN, EMİN HALİS; Özakın, Cüneyt; ÖZAKIN, CÜNEYT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları Anabilim Dalı.; 0000-0003-3544-3509; 0000-0001-7530-1279; A-4290-2018; AAU-8952-2020; AAG-8392-2021Objective: Optimizing colistin susceptibility testing has difficulties because of its high molecular weight and high binding capacity to polystyrene which is frequently used in antibiotic susceptibility testing. We aimed to compare the results of isolates, which were detected as colistin-resistant in the automated system, obtained by using broth microdilution (BMD) method which is the gold standard, with gradient diffusion method (GDM).Methods: We investigated 36 Klebsiella pneumoniae, 9 Acinetobacter baumannii and 5 Pseudomonas aeruginosa isolates, identified by the Phoenix (TM) 100 (Becton Dickinson, Sparks, MD, USA) automated system, isolated from various clinical specimens sent to the Central Microbiology Laboratory between August 2016 and April 2017. The susceptibility of the isolates was also tested by GDM and BMD method.Results: When the colistin resistance rates obtained from the gold standard BMD method were compared with the automated method, the categorical agreement (CA) rate of the automated system was 92% for all isolates, 100% for K. pneumoniae, 77.8% for A. baumannii, and 60% for P. aeruginosa. The very major error (VME) rate was 0%, and the major error (ME) rate was 8% for all isolates. When GDM was used for all isolates, CA was found to be 20% for all isolates, 16.7% for K. pneumoniae, 22.2% for P. aeruginosa and 40% for A. baumannii. VME was found to be 80%, and ME was %0 for all isolates.Conclusions: CA, VME and ME rates of Phoenix (TM) 100 for detecting colistin resistance is within acceptable limits according to ISO 20776 standard, but the rates of GDM is not suitable for this purpose.Publication Conventional amphotericin b associated nephrotoxicity in patients with hematologic malignancies(Cureus, 2021-07-17) Gürsoy, Vildan; Özkalemkaş, Fahir; Özkocaman, Vildan; Yeğen, Zafer Serenli; Pınar, İbrahim Ethem; Ener, Beyza; Akalın, Halis; Kazak, Esra; Ali, Rıdvan; Ersoy, Alparslan; ÖZKALEMKAŞ, FAHİR; ÖZKOCAMAN, VİLDAN; PINAR, İBRAHİM ETHEM; ENER, BEYZA; AKALIN, EMİN HALİS; ALİ, RIDVAN; ERSOY, ALPARSLAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Hematoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Nefroloji Bilim Dalı.; 0000-0001-9907-1498 ; 0000-0002-4803-8206; DLR-8474-2022 ; JIR-6730-2023 ; JGM-6601-2023 ; AAG-8523-2021 ; AAU-8952-2020; AAG-8459-2021; GXD-8209-2022; CPX-5894-2022Introduction: Amphotericin B (AmB-d) is one of the most effective therapeutic options against frequently life-threatening systemic fungal infections in patients with hematologic malignancies. However, significant adverse effects including nephrotoxicity associated with its use limit its more widespread use. The objectives of our study were to determine the incidence of AmB-d associated nephrotoxicity, to evaluate clinical and epidemiological characteristics of patients, and to support the notion that conventional amphotericin B remains a valid therapeutic option among hematologic patients with proper patient selection.Materials and methods: A total of 110 patients with hematologic malignancies were admitted to our Hematology Unit between January 2014 and November 2017 who required anti-fungal therapy during intensive systemic chemotherapy. The incidence of AmB-d associated nephrotoxicity, side effect profile, time to nephrotoxicity, and clinical and epidemiological characteristics associated with treatment success were assessed retrospectively.Results: Of the 110 patients receiving AmB-d, 70 (63.6%) were male and 40 (36.4%) were female. The mean age of participants was 44 years. The most common diagnosis was acute myeloid leukemia (n=53, 48.2%), and the most common chemotherapy protocol was 7 + 3 remission-induction (cytarabine 100 mg/m(2) days 1-7, Idarubicin 12 mg/m(2) days 1-3; n=24, 21.8%). In 56.4% of the patients, antifungal therapy was given empirically. In 40 patients (36.4%), nephrotoxicity was observed following antifungal treatment, and only four patients had stage 3 renal failure. The mean duration of time to nephrotoxicity from initiation of amphotericin B was four days (min: 2, max: 31). All patients were found to receive at least one additional potential nephrotoxic treatment during the antifungal treatment process.Conclusion: AmB-d is associated with a significant risk of nephrotoxicity. In most hematological patients, antifungal treatment is initiated empirically, and patients received prolonged courses of treatment. Therefore, it is plausible to initiate such treatment with AmB-d, when one considers the already high treatment costs in this patient group as well as the fact that AmB-d offers similar efficacy to antifungal agents at a lower cost. AmB-d may be recommended as a first-line agent in this patient group with the introduction of newer and more costly antifungal agents when needed, on the basis of the fact that these patients can be closely monitored in a hospital setting, reversible nature of nephrotoxicity upon discontinuation, and rare occurrence of severe renal failure requiring dialysis.Publication The age-dependent role of Th22, Tc22, and Tc17 cells in the severity of pneumonia in COVID-19 immunopathogenesis(Wiley, 2021-08) Şimşek, Abdurrahman; Çağan, Eren; Kızmaz, Muhammed Ali; Dombaz, Fatma; Tezcan, Gülçin; Asan, Ali; Demir, H. İbrahim; Bal, S. Haldun; Ermiş, Diğdem Yoyen; Demirdöğen, Ezgi; Heper, Yasemin; Akalın, E. Halis; Oral, Haluk Barbaros; Budak, Ferah; ŞİMŞEK, ABDURRAHMAN; TEZCAN, GÜLÇİN; BAL, SALİH HALDUN; DEMİRDÖĞEN, EZGİ; BUDAK, FERAH; HEPER, YASEMİN; AKALIN, EMİN HALİS; Kızmaz, Muhammed Ali; Dombaz, Fatma; YÖYEN ERMİŞ, DİĞDEM; ORAL, HALUK BARBAROS; Bursa Uludağ Üniversitesi/Tıp Fakültesi; 0000-0001-8850-0269; 0000-0001-5334-7911; 0000-0001-7288-3250; 0000-0002-5956-8755; 0000-0002-7400-9089; 0000-0001-7625-9148; AAG-7381-2021; HKN-2347-2023; DWR-5356-2022; KBR-5535-2024; GYL-2038-2022; AAH-9812-2021; CTY-9474-2022; AAU-8952-2020; IZP-9398-2023; K-7285-2012; AAH-3843-2020Publication Coronavirus disease 2019 and antibiotic stewardship-antibiotic usage in adult patients: Is it necessary? When should it be concerned?(Galenos Publ House, 2021-01-30) Önal, Uğur; Akalın, Halis; ÖNAL, UĞUR; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0001-6194-3254; 0000-0001-7530-1279; JCO-3678-2023; AAU-8952-2020; ACQ-7832-2022Antibiotic consumption rates were quite high in number, although the bacterial coinfection rates were low in coronavirus disease 2019 pneumonia. Generally, empirical antibiotic treatment is not recommended for uncomplicated coronavirus disease 2019 mild to moderate pneumonia cases. On the other hand, antibiotic treatment and de-escalation are recommended for intubated intensive care unit patients or critical patients with sepsis, septic shock, or acute respiratory distress syndrome. The presentation of patients with severe coronavirus disease 2019 pneumonia can direct the clinicians to use antibiotics. We believe that wait and watch strategy can be preferred in such cases without sepsis, secondary bacterial infection findings, or procalcitonin < 0.5 ng/mL. We think that a new wave of resistance will occur inevitably if we cannot perform the antibiotic stewardship properly.Publication Trends of bloodstream infections in a university hospital during 12 years(Polskie Towarzystwo Mikrobiologow-polish Society Of Microbiologists, 2022-09-24) Tuzemen, Nazmiye Ulku; Payaslioglu, Melda; Özakin, Cuneyt; Ener, Beyza; Akalin, Halis; Tuzemen, Nazmiye Ulku; TÜZEMEN, NAZMİYE ÜLKÜ; Payaslioglu, Melda; PAYASLIOĞLU, AYŞE MELDA; Ozakin, Cuneyt; ÖZAKIN, CÜNEYT; Ener, Beyza; ENER, BEYZA; Akalin, Halis; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0001-7530-1279; A-4290-2018; AAU-8952-2020This study aims to investigate trends in bloodstream infections and their antimicrobial susceptibility profiles over 12 years in our hospital. This retrospective study was carried out in the Bursa Uludag University Hospital, Turkey, during 2008-2019. Blood cultures from patients were performed using BACTEC System. Isolates were identified with Phoenix System until 2018 and "matrix-assisted laser desorption ionization time-of-flight mass spectrometry" (MALDI-TOF MS) in 2019. Antibiotic susceptibility testing was performed with Phoenix System. Patient data came from the BD EpiCenter (TM) data management system. Escherichia coli was found to be the most common Gram-negative (11.6%), and coagulase-negative staphylococci were the most common Gram-positive (10.1%) monomicrobial growth. Overall, there was a significant increase in rates of extended-spectrum beta-lactamase positive E. coli (p = 0.014) and Klebsiella pneumonia (p < 0.001), carbapenem-resistant E. coli (p < 0.001), and K. pneumoniae (p < 0.001) and colistin-resistant K. pneumoniae (p < 0.001) and Acinetobacter baumannii (p < 0.001) over 12 years. Carbapenem and colistin resistance has increased dramatically in recent years. We believe that regular monitoring of the distribution of pathogens and antibiotic susceptibility profiles, especially in intensive care units, can contribute to evidence for the increase in resistant microorganisms and help prevent their spread with antimicrobial stewardship and infection control policies.Publication In-vitro activity of fosfomycin against Escherichia coli and Klebsiella pneumoniae bloodstream isolates and frequency of OXA-48, NDM, KPC, VIM, IMP types of carbapenemases in the carbapenem-resistant groups(Taylor & Francis, 2021-07-28) Zarakolu, Pınar; Eser, Özgen Köseoğlu; Otlu, Barış; Gürpınar, Öznur; Özakın, Cüneyt; Akalın, Halis; Köksal, İftihar; Ünal, Serhat; ÖZAKIN, CÜNEYT; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; 0000-0001-5428-3630; 0000-0001-7530-1279; JGV-7010-2023 ; AAU-8952-2020The aim of this study was to determine the in-vitro activity of fosfomycin against Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) isolates and the frequency of OXA-48, NDM, KPC, VIM, IMP types of carbapenemases in the carbapenem-resistant (CR) groups. A total of 346 isolates (126 E. coli and 220 K. pneumoniae) from nosocomial bloodstream infections were included. Carbapenem and fosfomycin susceptibility were tested by Etest (bioMerieux, France) and agar dilution methods, respectively and evaluated in accordance with EUCAST criteria. The presence of OXA-48, NDM, KPC, VIM, IMP types of carbapenemases were conducted by using PCR method. Of the total 346 isolates, 185 (41 E. coli, 144 K. pneumoniae) were CR. Fosfomycin susceptibility of E. coli was higher than 95% and was not statistically significant between the CR and carbapenem-susceptible (CS) groups. Fosfomycin susceptibility of CS and CR K. pneumoniae was 90.7% and 69.4%, respectively, and statistically significantly lower in CR group. Of the total 185 CR isolates, 163 (32 E. coli, 131 K. pneumoniae) were producing carbapenemases. OXA-48 was the prominent carbapenemase type produced by E. coli (96.8%) and K. pneumoniae (70.9%). The frequency of NDM and KPC types produced by K. pneumoniae was 20.6% and 15.2%, respectively. Fosfomycin has substantial in-vitro activity against nosocomial CS and CR E. coli and CS K. pneumoniae bloodstream isolates. However, due to the risk of emerging resistance with fosfomycin monotherapy, combination therapy should be considered to obtain the possible additive or synergistic activity. Emerging fosfomycin resistance of CR K. pneumoniae isolates is alarming and OXA-48 is still the prominent carbapenemase type in Turkey.Publication Evaluation of the roles of regulatory B (Breg) cells and B cell exhaustion in COVID-19(Wiley, 2021-08-01) Budak, Ferah; Çağan, Eren; Kızmaz, Muhammed Ali; Şimşek, Abdurrahman; Dombaz, Fatma; Tezcan, Gülçin; Asan, Ali; Bal, S. Haldun; Ermiş, Diğdem Yöyen; Demir, H. İbrahim; Ediger, Dane; Yılmaz, Emel; Oral, Haluk Barbaros; Akalın, E. Halis; BUDAK, FERAH; Kızmaz, Muhammed Ali; ŞİMŞEK, ABDURRAHMAN; Dombaz, Fatma; TEZCAN, GÜLÇİN; BAL, SALİH HALDUN; YÖYEN ERMİŞ, DİĞDEM; Demir, H. İbrahim; EDİGER, DANE; YILMAZ, EMEL; ORAL, HALUK BARBAROS; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Diş Hekimliği Fakültesi/Temel Bilimler Bölümü.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Klinik Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı.; 0000-0001-7625-9148; 0000-0001-5334-7911; 0000-0001-8850-0269; 0000-0001-7288-3250; 0000-0002-5956-8755; 0000-0002-8856-7356; 0000-0001-7585-7971; 0000-0002-2954-4293; 0000-0003-1785-3539; 0000-0003-0463-6818; 0000-0001-7530-1279; AAG-7381-2021; AAH-3843-2020; K-7285-2012; F-4657-2014; IZP-9398-2023; AAU-8952-2020; HKN-2347-2023; DWR-5356-2022; KBR-5535-2024; GYL-2038-2022; GPN-1473-2022; AAE-9142-2019; GDP-0005-2022Publication Evaluation of indoleamine 2, 3 dioxygenase (IDO) gene polymorphisms in COVID-19(Wiley, 2021-08-01) Karaca, Mert; Arslan, Gözde; Ermiş, Diğdem Yöyen; Bal, Salih Haldun; Uzaslan, Esra Kunt; Özkalemkaş, Fahir; Macunluoğlu, Aslı Ceren; Budak, Ferah; Akalın, Halis; Oral, Haluk Barbaros; KARACA, MERT; Arslan, Gözde; YÖYEN ERMİŞ, DİĞDEM; BAL, SALİH HALDUN; Uzaslan, Esra Kunt; ÖZKALEMKAŞ, FAHİR; Macunluoğlu, Aslı Ceren; BUDAK, FERAH; AKALIN, EMİN HALİS; ORAL, HALUK BARBAROS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmunoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biostatik Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0002-6802-5998; 0000-0001-7625-9148; 0000-0001-7530-1279; 0000-0003-0463-6818; 0000-0002-6802-5998; 0000-0001-6711-676X; IZP-9398-2023; AAU-8952-2020; K-7285-2012; F-4657-2014; JFS-2013-2023; AAG-7406-2021; GYL-2038-2022; KBR-5535-2024; AAI-1004-2021; JLE-5241-2023; GBP-6589-2022Publication Comparison of clinical, laboratory, and radiological characteristics between COVID-19, influenza, and adenovirus pneumonia: A narrative review(Galenos Yayıncılık, 2021-01-01) Önal, Uğur; Ursavaş, Ahmet; Akalın, Halis; ÖNAL, UĞUR; URSAVAŞ, AHMET; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı; 0000-0001-6194-3254; 0000-0001-7530-1279; 0000-0001-6953-8499; ACQ-7832-2022; AAI-3169-2021; AAU-8952-2020; JCO-3678-2023The Coronavirus disease-2019 (COVID-2019) pandemic is a major global healthcare problem nowadays, and because of the high numbers of infected patients, it is vitally important to distinguish this from other types of viral pneumonia caused by influenza or adenovirus, which may have similar signs and symptoms. We conducted a narrative literature review and performed a PubMed and Scopus search for studies published up to November 18, 2020, using the following medical subject headings terms: ["comparison," "comparisons" AND "severe acute respiratory syndrome coronavirus 2," "ncov," "2019 ncov," "covid 19," "sars coy 2," "coronavirus," "coy" AND ("influenzas," "influenza," "influenzae," "human influenza" OR "adenoviridae," "adenovirus," "adenoviridae infections")]. This narrative review aims to compare pneumonia caused by severe acute respiratory syndrome coronavirus-2, influenza, and adenovirus in terms of clinical, laboratory, and radiological characteristics. In conclusion, although these viral pneumonia clinics share the similar patterns of symptoms and laboratory findings; we believe that there have some distrinctions especially in radiological findings.Publication A novel β-lactam-aminoglycoside combination in veterinary medicine: The couse of ceftiofur and gentamicin to combat resistant Escherichia coli(Hellenic Veterinary Medical Society, 2020-04-01) Cengiz, M.; Şahintürk, P.; Hepbostancı, G.; Akalın, H.; Sonal, S.; CENGİZ, MURAT; ŞAHİNTÜRK, SERDAR; AKALIN, EMİN HALİS; SONAL, SONGÜL; HEPBOSTANCI, G.; Bursa Uludağ Üniversitesi/Veteriner Fakültesi.; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; Bursa Uludağ Üniversitesi/Sağlık Bilimleri Enstitüsü.; 0000-0001-7530-1279; AAU-8952-2020; ABE-5935-2020The focus of this study was to evaluate the efficacy of ceftiofur+gentamicin combination to increase the success of antimicrobial inhibition against resistant Escherichia coli (E.coli) strains isolated from animals. Interaction between drugs was determined using checkerboard method and the fractional inhibitory concentration index was interpreted as synergism, antagonism and indifference. The combination was defined as bactericidal or bacteriostatic based on the minimum bactericidal test results. Mutant prevention concentration test was used to evaluate the resistance tendency suppression potential of the combination. The synergistic effect was detected for all E. coli strains by the checkerboard method; even the strains that were resistant to the individual compounds in the combination. Based on the results of minimum bactericidal concentration test, the combination exhibited bactericidal effect against all E. coli strains. In addition, the individual mutant prevention concentrations of ceftiofur and gentamicin decreased up to 125-fold by using the combination for the inhibition of resistant E. coli strains. The results indicated that killing potential of co-use of the compounds is much stronger than their individual use. The combination achieved to decrease the mutant prevention concentrations and this can reduce the risk of emergence of single mutations during treatment done with suggested doses.